Intensive weight management can reverse the commonest type of diabetes caused by the body’s inability to use insulin, a study by English researchers has found.
The study, published in The Lancet journal, shows that after one year, participants had lost an average 10 kg, and nearly half had reverted to a non-diabetic state without using any diabetes treatment.
“Rather than addressing the root cause, management guidelines for Type 2 diabetes focus on reducing blood sugar levels through drug treatments. Diet and lifestyle are touched upon but diabetes remission by cutting calories is rarely discussed,” said Prof Roy Taylor from Newcastle University, UK, who co-led the study.
Taylor said: “A major difference from other studies is that we advised a period of dietary weight loss with no increase in physical activity, but during the long-term follow-up increased daily activity is important. Bariatric surgery can achieve remission of diabetes in about three-quarters of people, but it is more expensive and risky, and is only available to a small number of patients.”
Diabetes Remission Clinical Trial (DiRECT) studied 298 adults aged 20-65 years who had been diagnosed with Type 2 diabetes in the last six years from 49 primary care practices across Scotland and the Tyneside region of England between July 2014 and August 2016.
Type 2 diabetes is a disease when the blood sugar level shoots up not because of lack of insulin but due to cells becoming resistant to it and not being able to use it optimally. It is usually the late onset variety of the disease. India has the dubious distinction of being the “diabetes capital” of the world.
According to the World Health Organisation, India had 69.2 million people with diabetes (8.7 per cent) as per 2015 data. Of these, it remained undiagnosed in more than 36 million people. Worldwide, the number of people with Type 2 diabetes has gone up nearly four times over 35 years — from 108 million in 1980 to 422 million in 2014. This is expected to rise to 642 million by 2040.
This increase has been linked to rising levels of obesity and the accumulation of intra-abdominal fat. Bariatric surgery, or gastric banding that is often used to treat morbid obesity or to control diabetes, can cost around Rs 5 lakh.
Taylor said: “Our findings suggest that the very large weight losses targeted by bariatric surgery are not essential to reverse the underlying processes which cause Type 2 diabetes. The weight loss goals provided by this programme are achievable for many people. The big challenge is long-term avoidance of weight re-gain. Follow-up of DiRECT will continue for 4 years and reveal whether weight loss and remission is achievable in the long-term.”